Benefits of using patient-specific cutting guides with dispo
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Total knee arthroplasty (TKA) is most frequently planned using conventional 2-D weight-bearing lower limb radiographs and is performed with conventional femoral and tibial cutting guides. Use of (CT)-based three-dimensional (3D) templating and patient-specific cutting guides printed in 3D has shown improved postoperative lower limb alignment parameters. This case-control study compared costs and operative times of using CT-based, patient-specific, single-use instruments versus conventional metal instruments for TKA.

In this case-control, retrospective chart review, all TKAs were performed by one senior surgeon, using the F.I.R.S.T. posterior-stabilised knee prosthesis (Symbios, CH), with a similar protocol and identical operating room setup.
-Group A included 51 TKAs performed with patient-specific cutting guides and conventional metal instruments.
-Group B included 49 TKAs performed with patient-specific cutting guides and patient-specific, single-use instrumentation.
Operation duration, number of instrumentation trays and sterilisation costs were evaluated.

--The groups were similar for age, body mass index, hip-knee-ankle angle and operation duration.

--The mean number of instrumentation trays was 8.0 ± 0.8 for group A (controls) and 5.1 ± 0.9 for group B.

--The mean sterilisation costs were 380 ± 47 Swiss Francs (CHF) for group A and 243 ± 55 CHF for group B, for a mean cost reduction of 130.50 CHF per intervention in group B.

--The time interval between two consecutive surgeries was 24 min for group A and 18 min for group B.

--There were no adverse events or complications, instrument-related or otherwise.

In conclusion, as opposed to traditional instrumentation, the use of patient-specific, single-use instruments for TKA decreased the number of instrumentation trays by more than one-third while saving 36% on sterilisation costs. When the business includes the fabrication costs of single-use instruments, the overall expense is greatly reduced. There was no gain in operative time for single-use instrumentation.